98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB5462

 

Introduced , by Rep. Thomas Morrison

 

SYNOPSIS AS INTRODUCED:
 
210 ILCS 5/3  from Ch. 111 1/2, par. 157-8.3
210 ILCS 5/6.2 new
210 ILCS 5/6.5
210 ILCS 5/10d  from Ch. 111 1/2, par. 157-8.10d
210 ILCS 5/10f  from Ch. 111 1/2, par. 157-8.10f
210 ILCS 5/10h new

    Amends the Ambulatory Surgical Treatment Center Act. Provides that "ambulatory surgical treatment center" includes any facility in which a medical or surgical procedure is utilized to terminate 50 or more pregnancies in any calendar year (instead of to terminate a pregnancy). Requires a physician to remain on the premises of an ambulatory surgical treatment center on any day when an abortion is performed at the facility and to have admitting privileges at a hospital that is located within 30 miles of the ambulatory surgical treatment center. Provides that any facility that performs more than 50 abortions in a calendar year shall comply with all of the statutes and rules that are applicable to ambulatory surgical treatment centers. Authorizes the Director of Public Health to seek an injunction against any facility that is in violation of the Act. Creates a private right of action against a facility or physician that performs an abortion in willful violation of the Act. Makes other changes.


LRB098 19268 RPS 54420 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB5462LRB098 19268 RPS 54420 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Ambulatory Surgical Treatment Center Act is
5amended by changing Sections 3, 6.5, 10d, and 10f and by adding
6Sections 6.2 and 10h as follows:
 
7    (210 ILCS 5/3)  (from Ch. 111 1/2, par. 157-8.3)
8    Sec. 3. As used in this Act, unless the context otherwise
9requires, the following words and phrases shall have the
10meanings ascribed to them:
11    (A) "Ambulatory surgical treatment center" means any
12institution, place or building devoted primarily to the
13maintenance and operation of facilities for the performance of
14surgical procedures or any facility in which a medical or
15surgical procedure is utilized to terminate 50 or more
16pregnancies in any calendar year a pregnancy, irrespective of
17whether the facility is devoted primarily to this purpose. Such
18facility shall not provide beds or other accommodations for the
19overnight stay of patients; however, facilities devoted
20exclusively to the treatment of children may provide
21accommodations and beds for their patients for up to 23 hours
22following admission. Individual patients shall be discharged
23in an ambulatory condition without danger to the continued well

 

 

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1being of the patients or shall be transferred to a hospital.
2    The term "ambulatory surgical treatment center" does not
3include any of the following:
4        (1) Any institution, place, building or agency
5    required to be licensed pursuant to the "Hospital Licensing
6    Act", approved July 1, 1953, as amended.
7        (2) Any person or institution required to be licensed
8    pursuant to the Nursing Home Care Act, the Specialized
9    Mental Health Rehabilitation Act, or the ID/DD Community
10    Care Act.
11        (3) Hospitals or ambulatory surgical treatment centers
12    maintained by the State or any department or agency
13    thereof, where such department or agency has authority
14    under law to establish and enforce standards for the
15    hospitals or ambulatory surgical treatment centers under
16    its management and control.
17        (4) Hospitals or ambulatory surgical treatment centers
18    maintained by the Federal Government or agencies thereof.
19        (5) Any place, agency, clinic, or practice, public or
20    private, whether organized for profit or not, devoted
21    exclusively to the performance of dental or oral surgical
22    procedures.
23    (B) "Person" means any individual, firm, partnership,
24corporation, company, association, or joint stock association,
25or the legal successor thereof.
26    (C) "Department" means the Department of Public Health of

 

 

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1the State of Illinois.
2    (D) "Director" means the Director of the Department of
3Public Health of the State of Illinois.
4    (E) "Physician" means a person licensed to practice
5medicine in all of its branches in the State of Illinois.
6    (F) "Dentist" means a person licensed to practice dentistry
7under the Illinois Dental Practice Act.
8    (G) "Podiatric physician" means a person licensed to
9practice podiatry under the Podiatric Medical Practice Act of
101987.
11    (H) "Abortion" means the act of using or prescribing any
12instrument, medicine, drug, method, or device or any other
13substance with the intent to terminate the clinically
14diagnosable pregnancy of a woman with knowledge that the
15termination by those means will, with reasonable likelihood,
16cause the death of the unborn child. "Abortion" does not
17include the use or prescription of any instrument, medicine,
18drug, method, or device or any other substance to terminate the
19clinically diagnosable pregnancy of a woman if done with the
20intent to save the life or preserve the health of the unborn
21child, remove a dead unborn child caused by spontaneous
22abortion, or remove an ectopic pregnancy.
23    (J) "Admitting privileges" means the right of a physician
24to admit patients to a particular hospital for the purposes of
25providing specific diagnostic or therapeutic services to the
26patient in that hospital.

 

 

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1    (K) "Born alive" means the complete expulsion or extraction
2of an infant from his or her mother, regardless of the state of
3gestational development, that, after expulsion or extraction,
4whether or not the umbilical cord has been cut or the placenta
5is attached, and regardless of whether the expulsion or
6extraction occurs as a result of natural or induced labor,
7cesarean section, or induced abortion, shows any evidence of
8life, including, but not limited to, breathing having a
9heartbeat, umbilical cord pulsation, or the definite movement
10of voluntary muscles.
11    (L) "Pregnancy" means the reproductive condition of having
12an unborn child in the woman's uterus.
13    (M) "Unborn child" means an individual of the species homo
14sapiens from fertilization to live birth.
15(Source: P.A. 97-38, eff. 6-28-11; 97-227, eff. 1-1-12; 97-813,
16eff. 7-13-12; 98-214, eff. 8-9-13.)
 
17    (210 ILCS 5/6.2 new)
18    Sec. 6.2. Exceptions and preferences for abortion clinics;
19other statutes and rules. Notwithstanding any other statute,
20rule, or regulation to the contrary, an ambulatory surgical
21treatment center utilized to terminate pregnancies must comply
22with all of the statutes, rules, and regulations generally
23applicable to other ambulatory surgical treatment centers. If
24an ambulatory surgical treatment center is required to perform
25construction or other physical renovation to comply with the

 

 

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1statutes, rules, and regulations applicable pursuant to this
2Act, then the ambulatory surgical treatment center shall
3complete any such construction or other physical renovation no
4later than January 1, 2016.
 
5    (210 ILCS 5/6.5)
6    Sec. 6.5. Clinical privileges; advanced practice nurses.
7All ambulatory surgical treatment centers (ASTC) licensed
8under this Act shall comply with the following requirements:
9    (1) No ASTC policy, rule, regulation, or practice shall be
10inconsistent with the provision of adequate collaboration and
11consultation in accordance with Section 54.5 of the Medical
12Practice Act of 1987.
13    (2) Operative surgical procedures shall be performed only
14by a physician licensed to practice medicine in all its
15branches under the Medical Practice Act of 1987, a dentist
16licensed under the Illinois Dental Practice Act, or a podiatric
17physician licensed under the Podiatric Medical Practice Act of
181987, with medical staff membership and surgical clinical
19privileges granted by the consulting committee of the ASTC. A
20licensed physician, dentist, or podiatric physician may be
21assisted by a physician licensed to practice medicine in all
22its branches, dentist, dental assistant, podiatric physician,
23licensed advanced practice nurse, licensed physician
24assistant, licensed registered nurse, licensed practical
25nurse, surgical assistant, surgical technician, or other

 

 

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1individuals granted clinical privileges to assist in surgery by
2the consulting committee of the ASTC. Payment for services
3rendered by an assistant in surgery who is not an ambulatory
4surgical treatment center employee shall be paid at the
5appropriate non-physician modifier rate if the payor would have
6made payment had the same services been provided by a
7physician.
8    (2.5) A registered nurse licensed under the Nurse Practice
9Act and qualified by training and experience in operating room
10nursing shall be present in the operating room and function as
11the circulating nurse during all invasive or operative
12procedures. For purposes of this paragraph (2.5), "circulating
13nurse" means a registered nurse who is responsible for
14coordinating all nursing care, patient safety needs, and the
15needs of the surgical team in the operating room during an
16invasive or operative procedure.
17    (3) An advanced practice nurse is not required to possess
18prescriptive authority or a written collaborative agreement
19meeting the requirements of the Nurse Practice Act to provide
20advanced practice nursing services in an ambulatory surgical
21treatment center. An advanced practice nurse must possess
22clinical privileges granted by the consulting medical staff
23committee and ambulatory surgical treatment center in order to
24provide services. Individual advanced practice nurses may also
25be granted clinical privileges to order, select, and administer
26medications, including controlled substances, to provide

 

 

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1delineated care. The attending physician must determine the
2advance practice nurse's role in providing care for his or her
3patients, except as otherwise provided in the consulting staff
4policies. The consulting medical staff committee shall
5periodically review the services of advanced practice nurses
6granted privileges.
7    (4) The anesthesia service shall be under the direction of
8a physician licensed to practice medicine in all its branches
9who has had specialized preparation or experience in the area
10or who has completed a residency in anesthesiology. An
11anesthesiologist, Board certified or Board eligible, is
12recommended. Anesthesia services may only be administered
13pursuant to the order of a physician licensed to practice
14medicine in all its branches, licensed dentist, or licensed
15podiatric physician.
16        (A) The individuals who, with clinical privileges
17    granted by the medical staff and ASTC, may administer
18    anesthesia services are limited to the following:
19            (i) an anesthesiologist; or
20            (ii) a physician licensed to practice medicine in
21        all its branches; or
22            (iii) a dentist with authority to administer
23        anesthesia under Section 8.1 of the Illinois Dental
24        Practice Act; or
25            (iv) a licensed certified registered nurse
26        anesthetist; or

 

 

HB5462- 8 -LRB098 19268 RPS 54420 b

1            (v) a podiatric physician licensed under the
2        Podiatric Medical Practice Act of 1987.
3        (B) For anesthesia services, an anesthesiologist shall
4    participate through discussion of and agreement with the
5    anesthesia plan and shall remain physically present and be
6    available on the premises during the delivery of anesthesia
7    services for diagnosis, consultation, and treatment of
8    emergency medical conditions. In the absence of 24-hour
9    availability of anesthesiologists with clinical
10    privileges, an alternate policy (requiring participation,
11    presence, and availability of a physician licensed to
12    practice medicine in all its branches) shall be developed
13    by the medical staff consulting committee in consultation
14    with the anesthesia service and included in the medical
15    staff consulting committee policies.
16        (C) A certified registered nurse anesthetist is not
17    required to possess prescriptive authority or a written
18    collaborative agreement meeting the requirements of
19    Section 65-35 of the Nurse Practice Act to provide
20    anesthesia services ordered by a licensed physician,
21    dentist, or podiatric physician. Licensed certified
22    registered nurse anesthetists are authorized to select,
23    order, and administer drugs and apply the appropriate
24    medical devices in the provision of anesthesia services
25    under the anesthesia plan agreed with by the
26    anesthesiologist or, in the absence of an available

 

 

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1    anesthesiologist with clinical privileges, agreed with by
2    the operating physician, operating dentist, or operating
3    podiatric physician in accordance with the medical staff
4    consulting committee policies of a licensed ambulatory
5    surgical treatment center.
6    (5) On any day when any abortion is performed in an
7ambulatory surgical treatment center, a physician who has
8admitting privileges at an accredited hospital that is located
9in this State and is located within 30 miles of the ambulatory
10surgical treatment center must remain on the premises of the
11ambulatory surgical treatment center to facilitate the
12transfer to a hospital, if necessary, of an abortion patient or
13a child born alive until all abortion patients are stable and
14ready to leave the post-surgical recovery room. Each day this
15Section is violated constitutes a separate violation for
16purposes of assessing civil penalties or fines.
17(Source: P.A. 98-214, eff. 8-9-13.)
 
18    (210 ILCS 5/10d)  (from Ch. 111 1/2, par. 157-8.10d)
19    Sec. 10d. Fines and penalties.
20    (a) When the Director determines that a facility has failed
21to comply with this Act or the Illinois Adverse Health Care
22Events Reporting Law of 2005 or any rule adopted under either
23of those Acts, the Department may issue a notice of fine
24assessment which shall specify the violations for which the
25fine is assessed. The Department may assess a fine of up to

 

 

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1$500 per violation per day commencing on the date the violation
2was identified and ending on the date the violation is
3corrected, or action is taken to suspend, revoke or deny
4renewal of the license, whichever comes first.
5    (b) In determining whether a fine is to be assessed or the
6amount of such fine, the Director shall consider the following
7factors:
8        (1) The gravity of the violation, including the
9    probability that death or serious physical or mental harm
10    to a patient will result or has resulted, the severity of
11    the actual or potential harm, and the extent to which the
12    provisions of the applicable statutes or rules were
13    violated;
14        (2) The reasonable diligence exercised by the licensee
15    and efforts to correct violations;
16        (3) The duration, frequency, and relevance of any Any
17    previous violations committed by the licensee; and
18        (4) The financial benefit to the facility or to the
19    licensee of committing or continuing the violation.
20    (c) The Attorney General or the State's Attorney for the
21county in which the violation occurred may bring an action in a
22court of competent jurisdiction to enforce the collection of
23civil penalties or fines.
24(Source: P.A. 94-242, eff. 7-18-05.)
 
25    (210 ILCS 5/10f)  (from Ch. 111 1/2, par. 157-8.10f)

 

 

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1    Sec. 10f. Denial, suspension, revocation or refusal to
2renew a license; suspension of a service.
3    (a) When the Director determines that there is or has been
4a substantial or continued failure to comply with this Act or
5any rule promulgated hereunder, the Department may issue an
6order of license denial, suspension or revocation, or refusal
7to renew a license, in accordance with subsection (a) of
8Section 10g of this Act.
9    (b) When the Director determines that a facility has failed
10to demonstrate the capacity to safely provide one or more of
11its services to patients, the Department may issue an order of
12service suspension in accordance with subsection (a) of Section
1310g of this Act.
14    (c) If, however, the Department finds that the public
15interest, health, safety, or welfare imperatively requires
16emergency action, and if the Director incorporates a finding to
17that effect in the order, summary suspension of a service or a
18license to open, conduct, operate, and maintain an ambulatory
19surgical treatment center or any part thereof may be ordered
20pending proceedings for license revocation or other action,
21which shall be promptly instituted and determined.
22    (d) In addition to any other penalty provided by law,
23whenever in the judgment of the Director any person has engaged
24or is about to engage in any acts or practices that constitute
25or will constitute a violation of this Act, the Director shall
26make application to any court of competent jurisdiction for an

 

 

HB5462- 12 -LRB098 19268 RPS 54420 b

1order enjoining those acts or practices. Upon a showing by the
2Director that the person has engaged or is about to engage in
3any of those acts or practices that constitute a violation of
4this Act, an injunction, restraining order, or other order as
5may be appropriate shall be granted by the court without bond.
6(Source: P.A. 86-1292.)
 
7    (210 ILCS 5/10h new)
8    Sec. 10h. Private right of action. A woman upon whom an
9abortion has been performed in violation of this Act, or, if
10the woman is an unemancipated minor, the parent or legal
11guardian of the woman, may commence a civil action for actual
12and punitive damages against the facility where the abortion
13was performed or the person who performed the abortion for any
14willful violation of this Act.